Newsletter Edition 2 Gotham Footcare

Live Life, "Feet First"

Gotham in the News

The 6 Best Cross-Training Shoes for Women

What the Color of Your Toenails Says About Your Health

How Can I Find The Best Podiatrist?

Ask DOCTOR GOTHAM

Dear Dr. Gotham,

 
I spend a lot of time on my feet at my job, and want to purchase insoles to help alleviate foot pain. How do I go about finding the best pair of insoles for my feet?
 
Sincerely,
Dr. Scholl’s or New Balance?

Dear Dr. Scholl’s,
 
When shopping for insoles one should consider which shoes the insole will be fitted into. Insoles come with different volumes to fit different type of shoes. For example, a high volume insole is best suited for hiking boots, ski boots or running shoes and typically works best with high arches.  Insoles with medium-volume work best with casual shoes and some athletic footwear and work best with a variety of arch types. Low-volume insoles work best with cycling shoes and work best with people with very low arches. 
 

Once you have decided on an orthotic, stand on the insole outside of the shoe and lift your other foot. Assess if you feel stable and your heel feels cupped and supported while standing on the insole. Next, remove the original insert of the shoe and replace it with the supportive insole. Make sure to fit the insoles into your shoes at the end of the day when your feet are most swollen. If the insoles feel comfortable then they will most likely feel comfortable throughout The day. Make sure to break in your insoles over the course of five days a two hour increments. Use the insoles for two hours the first day then take them out then four hours the next day, six hours the next day eight hours the next and the full day at the fifth day. This allows you to gradually adjust and accommodate to the orthotic which will also compress somewhat with your bodyweight. This will allow for a more comfortable transition in the short term and long term.

Sincerely,
Dr. Gotham

New Year's Resolutions... For Your Feet?

As the New Year begins, most people are making resolutions to eat healthier, exercise more and save money. While almost everyone will vow to be healthier in the new year, they likely haven’t considered making resolutions to take better care of their feet – the most neglected part of the body.

Dr. Cunha recommends a few New Year’s resolutions that will help improve the health of your feet – and subsequently your back, your gait and your overall alignment – and keep you out of the doctor’s office in 2019.
 

1. Start treating your feet like you do your teeth. Most people brush their teeth twice daily and have routine checkups each year. When was the last time you saw a Podiatrist, or even checked in on your own feet? Don’t neglect the symptoms of your feet – they are the literal foundation of your body and can be one of the first places to be impacted by illness. What’s more, minor foot issues now could lead to major issues down the road. This is especially true if you’re a diabetic with nerve issues that could leave you more susceptible to infections and further complications.
2. Pay attention to changes on your feet. Now that you are checking in regularly with the most used and most underappreciated parts of your body, pay attention to the color of your toenails, the quality of the skin around your heels and any changes to the shape of the foot. For example, yellow or brown and thickened nails are signs of fungal nails that can be easily treated by a Podiatrist. But, other colors could indicate larger health issues. For example, a black stripe on your nail could be a result of skin cancer, HIV or Lupus. 
3. Don’t walk barefoot ever (especially at the gym!). Walking barefoot on hard surfaces allows our foot to collapse which can lead to a tremendous amount of stress not only to the foot but to the rest of the body. Walking barefoot also exposes our feet to bacterial and fungal organisms that can infect the skin and nails. These organisms can lead to infections that change the appearance, smell, and comfort of the foot such as Athlete’s Foot or fungal nails. 
4. Ditch the flip flops. Okay, you can wear them for a short period, at the gym. But overall, walking with flip flops for prolonged periods of time allows our foot to collapse, impacting our gait and posture, which can lead to a tremendous amount of stress not only to the foot but to the rest of the body. This imbalance may increase the progression of underlying foot deformities such as bunions and hammertoes and lead to painful conditions associated with excessive pronation such as arch/ heel pain, shin splints/posterior tibial tendonitis, and Achilles Tendonitis.  
5. Pay better attention to your shoe gear overall. Whether it’s your favorite pair of black boots or your running sneakers, make sure that you don’t exhaust the lifeline of your shoe. Rotate your shoes frequently and do not hold on to a shoe when they are just plain worn out. Pay attention to the quality, fit, comfort, size and feel – not just the sale price.

Foot Care 101: How to treat a blister at home

Dr. Gotham was recently quoted in Well+Good sharing tips for getting rid of blisters quickly.

Whatever you do, do NOT remove the top layer of skin from your blister.  It will only cause the blister to become more painful and expose yourself to more bacteria which could develop into an infection. Instead, I recommend that you lance the blister. Take a clean needle, and poke the blister from the side to drain the fluid. Once the fluid is removed, the pressure will subside. Then soak your foot for 15-20 minutes in lukewarm water with Epsom salt. I also suggest using Betadine to help dry up the blister which will speed up the healing process.

Health Focus: Bunions

FACT: People avoid bunion surgery for as long as possible because they are afraid of the pain and recovery time involved.

 
FACT: Women are more likely to develop bunions because their footwear (heels!) requires the foot to contort in unnatural ways. More than one-third of women in America have bunions.
 
Until now there were limited options to treat a bunion: the Austin and Lapidus bunionectomy – removing the bone and realigning the toe with surgical hardware – that both produce good results but have a long recovery periods OR a minimally invasive approach that involves shaving the bone. The latter has less recovery time and shows an immediate aesthetic improvement of the foot, but doesn’t get to the root of the problem and often only provides 1-2 years of relief.

At Gotham Footcare we pride ourselves on performing conservative treatment first before the need for surgical intervention.

Non-surgical treatment options include:

• Shoe gear modification: Using wider shoes with larger toe boxes.
• Splinting, strapping, cushioning, and padding of the bunion.
• Custom orthoses to stabilize and slow progression of the deformity.
• Avoidance of activities that aggravate symptoms.
• Anti-inflammatory medication for periodic relief.
• Physical therapy to calm the inflammatory process.

Bunion surgery performed as an "outpatient" procedure, under monitored IV anesthesia. The primary goal of bunion surgery is to relieve the pain associated with the deformity. Bunion surgery consists of removing the pronounced bone, realigning the big toe, and balancing the foot so the bunion does not return. Dr. Cunha and the physicians at Gotham Footcare take pride in performing a more cosmetically pleasing incision performed on the inside of the foot rather than the typical bunion incision placed on top. The advantage of this technique is that one cannot see the incision looking straight down onto the top of one’s foot. It also helps to avoid casting or crutches and instead allows you to walk out of the operation in a post-operative boot or shoe.
 

Product Plug: ASICS Gel Kayano 24 or
ASICS Gel-Nimbus 18

If you suffer from Plantar Fasciitis, there are many things to consider when selecting the appropriate shoes. I recommend ASICS Gel Kayano 24 or ASICS Gel-Nimbus 18. These shoes offer a spacious toe box that allows your toes to move freely minimizing discomfort placed on the plantar fascia. They provide a well-cushioned footbed and anatomical arch support to hold the plantar fascia and prevent it from collapsing to minimize fatigue and pain. They also have a deep heel cup to maintain proper foot realignment and maintain pressure relieve of the plantar fascia with heel strike. This will maintain proper sagittal motion and minimize frontal plane motion which can lead to excessive pronation, collapse of the arch, and ultimately plantar fasciitis.

PATIENT TESTIMONIAL

I came here after an ankle injury that resulted in plantar fasciitis. I was in terrible pain and could barely walk with a walking boot, but after months of physical therapy and doing the Tenex procedure, I am now completely healed! I highly recommend Dr. Kim who has a great bedside manner and really cares about her patients and their recovery. The rest of the staff are absolutely lovely, they always remember your name and are very friendly. The offices are clean, bright and modern, and I would highly recommend Gotham Foot Care for any of my friends and family in need of a podiatrist.

- JULIA BUCHHEIM

The Tenex procedure is a minimally invasive procedure to identify and remove the pain generating scar tissue from the foot, which can occur due to various musculoskeletal conditions such as plantar fasciitis and achilles tendonitis. READ MORE